Bad Health Insurance Coverage/need Advice on Hefty Bills

A lot of offices are willing to write off a portion of the bills based on income. Have her call their billing office and talk with someone.

We do cortisone shots i don't recall that being the correct price but I don't really look at actual bills when I am running my reports. If I recall it is around $500 for crappy insurance. What it sounds like is the doctors office didn't take the contractual write down. Don't ask...okay, if you ever look at your EOB you will see a huge amount, then what is allowed, then what you pay. The difference between that huge amount and what is allowed is your contractual write down.

I would first contact the doctors office and have them explain the bill. If they are not forthcoming about the contractual write down I would ask about the write down. Don't call it a contractual write down cause you won't be able to back it up with knowledge in the field.

If you don't get any satisfaction from the doctors office contact the insurance company and ask if it is in network and what are the required contractual writes downs. To them it is okay to use the proper term cause they will already know you don't know squat but figure you know someone in the field.

If you still have no luck message me.

Can you tell I work next to our collectors and billing coders. :p

Alright! before this turns into healthcare bashing doctors have to bill that way! If they do not you don't even want to know how effed up all this would be. The price is set to get almost cost from Medicare and Medicaid! Okay!? Every doctors office will take the same write down if the people don't have insurance, got it!!! The problem comes in with insurance because then you are trapped by the wording of the contract so back the heck off of the doctors Malia! you don't know what you are talking about.

A couple of times I have called the doctor's office and got them to reduce the bill. It can't hurt to try.

She can call and try to negotiate the bill, everything is negotiable these days. I'm sure they would be willing to put her on a payment plan she can live with but I doubt she can get another shot until the bill is paid, that's how it works for me too :( 1500.00 out of pocket when I get a shot for my herniated disks, it sucks but I manage to pay it.
She needs to put into writing that the amount is a "hardship" due to her financial situation and mail it in with her negotiated amount that she feels she can pay.

You don't mention her age. If she is underinsured by either her insurance which may be cobra or her deceased husbands insurance and she doesn't have much of an income from unemployement she may be eligable for either a medicaid spend down or straight medicaid depending on her "value" I would call the doctors office and ask if they have had the experience that this amount is the usual and customary paid by this particular insurance. Was she in network? Assess her insurance plan. What is the deductable? what is the Max out of pocket? does she have to go to certain doctors? Did she need her primary physician to write a referral or it goes to an 80/20 not in her favor where she would pay 80? Assess how much she is paying for the insurance vs benefit. When talking to the office if you discover there is not another option of insurance coding for a better reimbursement, then ask if there is a discount...usually if they give a discount it is for an immediate payment in full or if not paid in full they give a payment plan on the full amount. However a payment plan may put off further treatments until the amount is closer to being paid off. Call your local insurance agencies like State Farm or Country Companies and see what they offer. If she is able to work she may want to see what jobs offer insurance even at part time.
I have dealt with bills from my father for the past 3 years and he has been deceased for 19 months and new ones keep popping up and there was a situation with his insurance and how his former employer handled things. So good luck and be diligent.

Like they said, she can try and call and let them know how much insurance covered. For a bill that size, $200 is hardly anything! It's basically like she's paying out of pocket. I know that often people who are paying cash get a discount. Maybe they could give her that discount.

And, with a payment plan, she can very likely go as small as she needs to go with payments. They won't charge interest (at least, none of ours ever have!), they are just glad to get paid.

Sorry, but I don't have a solution for you. I also am self-insured with a very high deductible. I have begun to ask the price for every medical visit and procedure before I agree to it. The doctors and nurses are surprised when I ask, but I don't care. I am not going to have them perform any test or procedure without knowing what it will cost me. My clinic now has a phone number to call to get this information.

I feel so badly for her. This is terrible. I have terrible coverage too. In addition to my hefty monthly premium, I have a high deductible and get some huge doctor bills. With the discounts people without insurance get, I wonder if going without insurance might be better sometimes.
Some hospitals/doctors will give a prompt payment discount, meaning if you pay in full, without any type of payment plan, they might decrease your bill by 25%. Hope this helps.

even with crappy insurance - the insurance should've picked up more than $200 - i wonder if it was coded properly..

Call the doctors office as well as the insurance company - find out if there is a deductible that needed to be met or if it was coded wrong. If it wasn't talk to them about writing off a portion of it - many doctors offices do this..

GOOD LUCK!!

Paying medical bills is tough. I, too, have started to ask the price of things because of having to meet a deductible. It can't hurt for her to ask to have her bill reduced or written off...if you don't ask, you don't get. What I would suggest, though, is to talk to Diane Merna of Adler Associates to see if she can get better coverage going forward. Her number is ###-###-#### x 104. Tell her S. sent you. Good luck!

I am not an expert, just and expert at reading advice columns :). I have read that there usually is some type of senior help on the county or state level that may also provide you and your mother with additional information or even programs she could look into. Best of luck.

What is so frustrating, is that people that do have insurance, pay very little, and the insurance company pays a portion, and the rest is written off!

For example, I've had over $3000 in billable things in the last few months... I've paid less than $400, probably, and the insurance company has paid maybe $1400? The rest is just written off. (My bloodwork, for example, showed billable charges for over $500... the insurance company paid about $52.... the rest was written off.... I didn't have to pay anything for that....)

Why can't they do that to the people, like your mother, that really need the help? Why can't costs in general just be lowered?

Something really does need to change in the medical billing/insurance area.....

(I am fortunate to have good insurance right now.. I'm paying probably $400 a month for hubby and I, zero deductible with 80/20 there also..... but... we were uninsured for quite a while, also.. hubby was laid off almost 3 years ago, and I finally got a job with insurance a year ago.....I still need things done, but that is going to involve surgery, and even with my insurance I'm not sure how I'm going to pay for it.)

Generally the doctors and offices don't help you if you have health insurance, even if it doesn't pay much. She can pay $50 a month until it's paid off.

I don't know where the doctor or hospital is, but tell her (or you) to make a payment plan or forgive the debt with their financial counselor.